药物治疗对大骨节病患者血清氧化损伤的影响研究

Effect of Therapeutics on Serum Oxidized Injury in Kaschin-beck Disease Patients

目的采用3种不同的方法药物治疗青海省大骨节病患者,探讨其对患者血清氧化损伤指标的影响。方法选择在青海省贵德县、兴海县和班玛县大骨节病病区居住的大骨节病患者274例,采用随机数字表法将患者分为A组(n=91)、B组(n=89)、C组(Al=94)。A组患者给予塞来昔布+小活络丸(浓缩丸);B组患者给予塞来昔布+壮骨关节丸;C组患者给予塞来昔布+抗骨质增生片,均治疗3个疗程,于治疗6个月后观察治疗效果。于治疗前后采用酶联免疫吸附试验(ELISA)检测患者血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GPX)、一氧化氮合酶(NOS)和诱导型ー氧化氮合酶(iNOS)的活性。结果 A组显效11例(12.09%),有效62例(68.13%),无效18例(19.78%);B组显效6例(6.74%),有效63例(70.79%),无效20例(22.47%);C组显效11例(11.70%),有效62例(65.96%),无效21例(22.34%)。3组患者临床疗效比较,差异无统计学意义(P>0.05)。治疗前、后,3组患者血清SOD、GPX、NOS、iNOS活性比较,差异均无统计学意义(P>0.05)。3组患者治疗后血清SOD活性较治疗前均升高(P<0.05);3组患者治疗后血清GPX、NOS、iNOS活性与治疗前比较,差异均无统计学意义(P>0.05)。结论 3种治疗方法均取得一定疗效,但均不能根治大骨节病;3种治疗方法均能升高血清SOD活性,对GPX、NOS和iNOS活性无影响。

Objective To investigate the effect of three kinds of drug treatment methods on serum oxidized injury indexes in Kashin - beck disease （KBD） patients in Qinghai. Methods 274 subjects from KBD areas of Guide, Xinghai and Banma city in Qinghai were randomly divided into 3 groups. A group （n =91） was received celecoxib ＋ xiaohuoluo pills （concentrated pill）. B group （n = 89） was received celecoxib ＋ zhuang gu guan jie pills, C group （n =94） was received celecoxib ＋ resistance to bone hyperplasia. The clinical effect was observed in the three groups after six months. The contents of superoxide dismutase （SOD）,nitric oxid synthase （NOS） , inducible nitric oxid synthase （iNOS） and glutathione peroxidae （GPX） were detected by ELISA before and after treatment in three groups. Results 11 cases （12. 09% ） were excellent, 62 cases （68. 13% ） were effective, 18 cases （19. 78% ） were invalid in A group; 6 cases （6. 74% ） were excellent, 63 cases （70. 79% ） were effective, 20 cases （22.47%） were invalid in B group; 11 cases （11. 70% ） were excellent, 62 cases （65. 96% ） were effective, 21 cases （22. 34% ） were invalid in C group; the clinical efficacy was not significant difference among three group （P 〉0. 05 ）. There was no significant difference in serum SOD, GPX, NOS, iNOS activity between the two groups before and after treatment （ P 〉 0. 05 ）. The serum SOD activity after treatment was higher than that in before treatment in three groups （P 〉 0. 05 ） , and there was no significant difference in GPX, NOS, iNOS activity between before and after treatment in three groups （P 〉 0. 05 ）. Conclusion Three treatment programs had certain curative effect, but cannot cure KBD. Three treatment programs can increase the serum SOD activity, no effect on GPX, NOS and iNOS activities.